Spectrum of Upper GI Endoscopy in Pediatric Population at a Tertiary Care Centre in Pakistan

Muhammad Rehan Khan, Shakeel Ahmed, Syed Rehan Ali, Prem Kumar Maheshwari, Muhammad Saad Jamal

Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan.

DOI: 10.4236/ojped.2014.43025                

Abstract

Although upper GI endoscopy is considered to be a gold standard in diagnosis of many pediatric gastrointestinal disorders, there is limited data about its utility from developing countries. We carried out this retrospective study at Aga khan University Hospital, Karachi, Pakistan from 2008-2012. During the study period, a total of 200 procedures were performed. Mean age of patients was 8.5 years. 66% of patients received general anesthesia for the procedure. Failure to thrive with suspected coeliac disease was the most common indication for the procedure, seen in 31% of patients. Gastritis was the most common abnormal endoscopic finding, seen in 14.5% of patients. Gastritis was the most common histopathological finding on biopsy, seen in 31% of the patients (n = 62). Findings were consistent with coeliac disease in 18% (n = 36), duodenitis, 10.5% (n = 21) and esophagitis, 4% (n = 8) of patients. No immediate post procedure complication was noted in our study.

Keywords

Upper GI Endoscopy, Children, Indications

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	El-Mouzan, M.I., Abdullah, A.M., Al-Sanie, A.M., et al. (2001) Pattern of Gastro Esophageal Reflux in Children. Saudi Medical Journal, 22, 419-422.
[2]	Sircus, W. (2003) Milestones in the Evolution of Endoscopy: A Short History. Journal of the Royal College of Physicians of Edinburgh, 33, 124-134.
[3]	Haight, M. and Thomas, D.W. (1995) Pediatric Gastrointestinal Endoscopy. Gastroenterologist, 3, 181-186.
[4]	Franciosi, J.P., Fiorino, K., Ruchelli, E., et al. (2010) Changing Indications for Upper Endoscopy in Children during a 20-Year Period. Journal of Pediatric Gastroenterology & Nutrition, 51, 443-447. http://dx.doi.org/10.1097/MPG.0b013e3181d67bee
[5]	Papp, J.P. (1973) Endoscopic Experience in 100 Consecutive Cases with the Olympus GIG Endoscope. The American Journal of Gastroenterology, 60, 466-472.
[6]	Gleason, W.A., Tedesco, F.J., Keating, J.P., et al. (1974) Fiber Optic Gastrointestinal Endoscopy in Infants and Children. The Journal of Pediatrics, 85, 810-813. http://dx.doi.org/10.1016/S0022-3476(74)80347-1
[7]	Graham, D.Y., Klish, W.J., Ferry, G.D., et al. (1978) Value of Fiber Optic Gastrointestinal Endoscopy in Infants and Children. Saudi Medical Journal, 71, 558-560. http://dx.doi.org/10.1097/00007611-197805000-00022
[8]	Ginger, M.A. (2001) Gastroenterologic Endoscopy in Children: Past, Present and Future. Current Opinion in Pediatric, 13, 429-434. http://dx.doi.org/10.1097/00008480-200110000-00008
[9]	Okello, T.R. (2006) Upper Gastrointestinal Endoscopic Findings in Adolescents at Lacor Hospital, Uganda. African Health Sciences, 6, 39-42.
[10]	El-Mouzan, M.I., Al-Mofleh, I.A., Abdullah, A.M., et al. (2004) Indications and Yield of Upper Gastrointestinal Endoscopy in Children. Saudi Medical Journal, 25, 1223-1225.
[11]	Aduful, H., Naaeder, S., Darko, R., et al. (2007) Upper Gastrointestinal Endoscopy at the Korle Bu Teaching Hospital, Accra, Ghana. Ghana Medical Journal, 41, 12-16.
[12]	Murray, J.A., Van Dyke, C., Plevak, M.F., et al. (2003) Trends in the Identification and Clinical Features of Celiac Disease in a North American Community, 1950-2001. Clinical Gastroenterology and Hepatology, 1, 19-27. http://dx.doi.org/10.1053/jcgh.2003.50004
[13]	Joshi, M.R., Sharma, S.K. and Baral, M.R. (2005) Upper GI Endoscopy in Children- in an Adult Suite. Kathmandu University Medical Journal (KUMJ), 3, 111-114.
[14]	Mudawi, H.M., El Tahir, M.A., Suleiman, S.H., et al. (2009) Paediatric Gastrointestinal Endoscopy: Experience in a Sudanese University Hospital. Eastern Mediterranean Health Journal, 15, 1027-1031.
[15]	Hafeez, A., Ali, S. and Hassan, M. (2000) An Audit of Pediatric Upper Gastrointestinal Endoscopies. Journal of the College of Physicians and Surgeons Pakistan, 10, 13-15.
[16]	Jantchou, P., Schirrer, J. and Bocquet, A. (2007) Appropriateness of Upper Gastrointestinal Endoscopy in Children: A Retrospective Study. Journal of Pediatric Gastroenterology and Nutrition, 44, 440-445. http://dx.doi.org/10.1097/MPG.0b013e31802c6847
[17]	Quine, M.A., Bell, G.D., McCloy, R.F., et al. (1994) Appropriate Use of Upper Gastrointestinal Endoscopy—A Prospective Audit. Steering Group of the Upper Gastrointestinal Endoscopy Audit Committee. Gut, 35, 1209-1214. http://dx.doi.org/10.1136/gut.35.9.1209
[18]	Bishop, P.R., Nowicki, M.J., May, W.L., et al. (2002) Unsedated Upper Endoscopy in Children. Gastrointestinal Endoscopy, 55, 624-630. http://dx.doi.org/10.1067/mge.2002.123417
[19]	Armstrong, D., Barkun, A., Bridges, R., et al. (2012) Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy. Canadian Journal of Gastroenterology, 26, 17-31.
[20]	ASGE Standards of Practice Committee, Ben-Menachem, T., Decker, G.A., et al. (2012) Adverse Events of Upper GI Endoscopy. Gastrointestinal Endoscopy, 76, 707-718. http://dx.doi.org/10.1016/j.gie.2012.03.252